RPL (9511-002)77365 Loma Vista
9511-002
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my
License is in full force and effect. 656178 C53 10131/96
License # Lic. Class ,Exp. Date r `
Date //-- />Signature ofContractor /)i _.Vy% - l., /, f'
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason:
( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044, Business & Professionals Code).
( ) .1, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec. 7044, Business & Professionals Code).
( ) I am exempt under Section , B&P.C. for this reason
Date Signature of Owner
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
( ) I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
() I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation insurance carrier & policy no. are:
Carrier t At. C()A4P Policy No. W945001411
(This section need not be completed if the permit valuation is for $100.00 or less).
( ) I certify that in the performance of the work for which this permit is issued,
I shall not employ any person in any manner so as to become subject to the
workers' compensation laws of California, and agree that if I should become
subject to the workers' compensation provisions of Section 3700 of the Labor
Code, I shall forthwith comply with those provisions.
Date: Applicant
Warning: Failure to secure Workers' Compensation coverage is unlawful and shall
subject an employer to criminal penalties and civil fines up to $100,000, in
addition to the cost of compensation, damages as provided for in Section 3706
of the Labor Code, interest and attorney's fees.
IMPORTANT Application is hereby made to the Director of Building and Safety
for a permit subject to the conditions and restrictions set forth on his application.
1. Each person upon whose behalf this application is made & each person at.
whose request and for whose benefit work is performed under or pursuant to
any permit issued as a result of this application agrees to, & shall, indemnify
& hold harmless the City of Indian Wells, its officers, agents and employees.
2. Any permit issued as a result of this application becomes null and void if
work is not commenced within 180 days from date of issuance of such
permit, or cessation of work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is
correct. I agree to comply with all City, and State laws relating to the building
construction, and hereby authorize representatives of this City to enter upon the
above-mentioned property for Inspection purposes.
yff
Signature (Owner/Agent) c c ,1 °u L• - " Date
A`°x
__BUILDING PERMIT
PERMIT rd
DATE 11 if, 1795
VALUATION
LOT
TRACT
JOB SITE ADDRESS 77 365 .L,C9MA VISTA,
APN 631-810-6,111.
OWNER
CONTRACTOR
C.ALIFORNTA POOLS & SPr18
EJ &PAM. CIA. WE,E,ISENHEUM R
41910:ROf RDWAA.LK #tA2
77363 LORN VISTA
PALM 17ES:E'wr CA. 9.2260
CAQIJIN-r.A CA 92253
($19)340.9000 CBL$# 355
(619)346.3366
DESIGNEWENGINEER
USE OF PERMIT'(.)i. L APd1XOR. SPA.
FEE DESCRIPTION
FEES
CONTRACT AMOUNT 12,000.00 L'S
F.SalY1Fl..8 r.' YGO ♦➢QJNIML9R S.
PLAN C.WCK FEE 101.400439-318 $87.75
CONSTRUCTION FF.E 101.000=4.18-000 $135.00
M C1i LNICALFEE--POOL 101-000-1121-000 S7A.00
Jd'
,
1,L''R-. rRfCAL FEE --1 001, 101-000-420-000 WkO
PLI,WBfNWIlu -- POOL 1.0J4)00 -4194W $27.00
D
OV 01 1995
By
SUB -TUBAL CONSTRUCrJON ARD FLAN CHECK
$3.18.75
LESS PRE -PAID FRES
$0.00
T 0I'AF, PERM,ff FEII?S 'DLIIIN.,.°°Ft: W
5"13.75
TOTAL-PRO.lr . J FERINra r FEUS
318.75
RECEIPT
DATE
BY
DATE RNALED
INSPECTOR
INSPECTION RECORD
OPERATION
DATE
INSPECTOR
OPERATION
DATE
INSPECTOR
BUILDING APPROVALS
MECHANICAL APPROVALS
Set Backs
Underground Ducts
Forms & Footings
Ducts
Slab Grade
Return Air
Steel
Combustion Air
Roof Deck
Exhaust Fans
O.K. to Wrap
F.A.U.
Framing
Compressor
Insulation
Vents
Fireplace P.L.
Grills
Fireplace T.O.
Fans & Controls
Party Wali Insulation
Condensate Lines
Party Wall Firewall
Exterior Lath
Drywall - Int. Lath
Final
Final
POOLS - SPAS
BLOCKWALL APPROVALS
Steel
Set Backs
Electric Bond
Footings
Main Drain
Bond Beam
Approval to Cover
Equipment Location
Underground Electric
Underground Plbg. Test
2Z ps—
Final
Gas Piping
PLUMBING APPROVALS
Gas Test
ZZ
Electric Final
Waste Lines
Heater Final
Water Piping
Plumbing Final
Plumbing Top Out
Equipment Enclosure
Shower Pans
O.K for Finish Plaster
Sewer Lateral
Pool Cover
Sewer Connection
Encapsulation
Gas Piping
Gas Test
Appliances
Final
COMMENTS:
Final—
Utility Notice (Gas)
ELECTRICAL APPROVALS
Temp. Power Pole
Underground Conduit
Rough Wiring
Low Voltage Wiring
Fixtures
Main Service
Sub Panels
Exterior Receptacles
G.F.I.
Smoke Detectors
Temp. Use of Power
Final
Utility Notice (Perm)
RAPS -0,v s� AT + ILII
WITH LIMF�.f('anl� eAP-
�Y oTr�E�
Arch • Eng. Supply Co. 557-869,
SPECIFICATION
C'1y N E
Type � ------ Size
.. .. .. ..
Surface Area r a Po _ — --- - - - - -
t_
. - c Perimeter Depths Min �e�
SPA SPECIFICATIONS ELECTRICAL"
�_ %t�� 13,A'3A► Size = x L2— Sq. Ft. --- - By C.00. Length 09)
3
/ .% -_ C�.--- ------
Spa Dam Walt Width_ Time Clock
�t j_1—Sub Panel f ' ,
�I�Iv, OI•�Fi CAP No of Jets - No of Lights in Pool �T/OQ � t / u� cq4 �flt
P
��� 1� J p e' 1 f�i✓ Light �l rte, Booster Pump Outside G F I. Lights "'�• GFI Outlet �.,�'T.
Y
Calif. Aqua Air -Barg Blower '�-"' Extra Switch for Spa Light _
Blower Only D HPi 'IO 7S Blank Plugs
• t{ --"".;,� ti : � �t fro l' • -��1-� ' � �
Raised Spa r�"��" Spillways Motor 2� Booster
-•.a , Special Notes' 1' A�� -j Blower Cleaner
A, ---- --- - —
: _12r
ION i c
- .• � .. SHOWER EXCAV
`:.: € �� • - (!u Type
i
` $EN(II _
cess From ----- ;COP NG & LE
M
• �.� , Elevationr`'�C T 7" r%Ec�aV,4 Coping White TIS
\= # ! Deep End Ramp Coping Special
V j F Fence Removed By Tile Type_-
... ,
<CJ - Fence Type -- - Tile Trim Mastic
)_ Trash RemovalLoads 6"R.B.B.-'' 12"R'BB 18"R.B.B/�'
/f Concrete Removal �....... - -- Loads Misc
Tree Removal By -" -- --- ---
Stump Removal By
Dirt Pad Ft DECKING
i I 12"RB.B. 18"RBB.6" R.B B
By ..z. Up To Sq. Ft.
Watkout•Misc. ":".•.- Finish _.""" Color
Rock Pack ^-
t Expansion Joints
• Mastic Footing
STEEL Steps — '^"^' Type
Expansive Soil Cantilever
s 6., R.B B. 12" R.B.B a' 18" R.B.B =' Deck Drains Curb Core --�
Surcharge Deep End Ramp Decco Drain Diving Board Jig
Loveseat Inside ` " Outside " Patio Straps & Footing --No.
Spa Wall Width!' - Other Slide Installation
Wall Dowel/Misc. MASONRY
T -Bars Deck Dowels
Coping
- 9 Type - -
Planter Wali
PLUMBING Type _ -' x
Filter14 ,,.4 Size Cap -. Back UD Wall .---
Pool Pump Or Size Footings ^~ R B.B. Facing
Heater O Size tO • Firepit Type Size
Booster Pump I iitj-t P, Size 1 Equip. Wall Type x
Skimmer Type � .6?—QsiA L�i Fencing
! Caretaker No of Heads �� Misc.
i R su t A s Pot 1 t+ Ji► 4 6G *
Other Cleaner Stub Only 1 A�1— a!t?Ca oK +MIC A'I
Fill Line Slide Line _ ASTER VCIA12 0 1 lM
i -
P•Trap B Ck Wash t0
Lights Pool Z' ` R Ik$pa
Gas Line agel MCI Stubs _
' Fountains/ � Rope ��r�ra•g��s ,...-• �S Eyeballs Required
EXISTING RESIDENCE N ColorLScf'7! Name Tile
t Sprayheads AIbZ .ft A �iT -___
Lights m Pool y Kin pa i
_. � Caretaker Aqua Air Bar �•.
POOL ARF TO BE ENCLOSED BY Hydrostatic Valve
_...v ._ -- _ - w.
SPECIAL EQUIPMENT •
�— H IGH -FENCE.
MINIM oartf _—Size'
I� � ��i
'Solar Run s Diving `B `
r Model Color
tt G T 'T?) +ar. I_F-CLOSING Sawcut -�-•- Auger
*t l (3) . MisC!- ' 2 S
r7S I�'i 4 fL t ^i F _ _ Size
i.. ' Mel __ __ Color
gg u'ATlrE Of Cover Solar HeatingYes -_ No ✓
F -un?a Inspection Required Yes I/ No _
._.- ..�- Misc.`'-�••-►- --B y
Rope Rings GrabRails
'
P End Ramp FENCING
I B.B. r" 12"RBB t 8" R B B'r To Meet All Local Code Requirements By Buyer Prior to
I
seat �E Extended 2nd StepPreplaster Inspection
hBondBeam - g OTHER wm,G "o rIt PCX S� �I2,t�091s2ic�vmg _ - Cantilever CD�r srNS
/ No hed Spa Dam Wall K+h�'E tlflll�'Ii• .L 7 t- , l
SP Dam Wa11Width 17-11 F! k _f-*'t���
r . + •- R 1 -+ �+n^ 0 NER RESPONSIBILITIES ►^�+�, ��" a=<i+��E�» rte• s7iEwit S- I
- _ . d�� S� I' ��d I�ic,,fy,��"4ic �i'.I..I.��I�i'a fJ C�SCp• layout IY6Z -T
` tit jr A+ t ,Tr r r r;r n A Ow er To. (1) Determine the approximate elevation of pool or spa at on Day oT Excavation
�IG� :.� # '-'` - (2) Take notice that Pool and Equipment location is subject to acceptance of local Building Depart- i
• ,i , �,�,z= 4 r • � ;< merit at time of issuance of permit
installed.� 1
_ (3) Wet down concrete shelf at least twice daily for seven (7) days after day shell is
in' �/{) I (4) Take Notice that California Pools IS NOT RESPONSIBLE for Underground conditions or objects, i
1 V Y i Vd ' �, :.�®' ��� E 1®n I n �J and any Damage to curbs, sidewalks, driveways, lawns. or other items in access area
r
�p (5) See that all fencing, gates, and garage doors meet local codes for a pool enclosure prior to
~. K t' V I /kiloaPreplaster inspection
(6) Fill pool immediately after plastar. (Follow Instructions. Do not use Rubber Hose)
•..t (7) Take Notice that this drawing is the sole property y use without written
• - g � p perty of California Pools and an
• 4 ' _ y __ ( permission of California Pools, Inc is prohibited by law
Owner approves Plan, Pool, and Equipment Locations and has read the Responsibilities and NOTICES above.
rEit A
l3t%6� -TYP Signed Date
(3 SWIMMING POOL PLAN FOR:
!r 1
�� ', h. .€ .°' + '�� i � •Y�' r k I NAME
WEISENHEIMER RESIDENCE -___--
STREET n -36S LOMA VISTA _
1 o I JOB ADDRESS LOT 1130 ENCLAVE MO NTAIN ESTATES — _CIT LA OUINTA
CITY -
f f PHONE OFFICE RES
LOT TRACT PAGE BOOK
A "J,A•f !1 1
MAP BOOK PAGE NO.
�`. MAIL ADDRESS CITY
t'lMSW ^r 'f' P>1t CONSTRUCTION OFFICE PHONE NO.
SCALE DATE
s DRAWN BY^-TSOLD BY CHECKED BY
_ - ., .9 CRAIG PAT PAT
r � Y ~V GaRr
.�•� t� yl��
Mr.«i1MA Dnnix- z t=q. �